RFK Jr.’s End Game

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Robert F. Kennedy Jr. is finally getting his wish of sucker punching the federal health agencies. This week, Kennedy began the process of firing some 10,000 employees working under the Health and Human Services umbrella. Even before he took office, Kennedy warned health officials that they should pack their bags, and on Tuesday, he defended the cuts: “What we’ve been doing isn’t working,” Kennedy posted on X. He is focused on “realigning HHS with its core mission: to stop the chronic disease epidemic and Make America Healthy Again.” But instead of improving how the federal health bureaucracy works, RFK Jr. is throwing his agencies into chaos.

The Trump administration hasn’t released details about which offices specifically were targeted, but the cuts seem to be so deep and indiscriminate that they are going to hamstring Kennedy’s own stated priorities. Kennedy has made clear that he’s singularly focused on reducing rates of chronic disease in America, but the health secretary has reportedly laid off officials in the CDC’s office tasked with that same goal. While cigarette smoking remains a leading cause of chronic disease, the top FDA official in charge of regulating tobacco is now on administrative leave, and everyone working for the CDC office that monitors tobacco use has been fired, according to the former CDC director Tom Frieden. Despite Kennedy’s promises to establish a culture of “radical transparency” at the federal agencies, he also appears to have fired the employees whom journalists and the greater public rely on to provide essential updates about the government’s actions. (In a statement, a spokesperson for HHS said that the personnel cuts were focused on “redundant or unnecessary administrative positions.”)

Kennedy, an anti-vaccine advocate, seems to have targeted more than just the most pro-vaccine voices in the government. During his confirmation hearings, Kennedy said he would “empower the scientists” as health secretary, but here are just a few of the M.D. and Ph.D.s who were reportedly targeted yesterday: the head of the FDA’s Office of New Drugs, the head of the National Institute of Allergy and Infectious Diseases, the director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, the head of CDC’s Center for Forecasting and Outbreak Analytics, the director of the National Institute of Child Health and Human Development, the director of the NIH’s Division of Microbiology and Infectious Diseases, the director of the National Institute of Nursing Research, and the director of the National Institute on Minority Health and Health Disparities.

No plan—not his MAHA agenda, not efficiency, nothing—can realistically explain cuts like these. Instead, the mass firings don’t seem to be a means to an end on the way to overhauling American health. They are an end in themselves.

It’ll take months, if not years, to fully appreciate the effect that the cuts will have on America’s scientific enterprise. The decimation at the FDA is particularly galling. Several of the agency’s top leaders charged with reviewing and approving innovative new treatments have been ushered to the exit. This is likely to lead to slower development of advancements in biomedical science; although the FDA doesn’t fund biomedical research, its leaders play a crucial role in advising pharmaceutical companies on how to conduct research and ultimately get their breakthroughs approved. America was just beginning to reap the benefits of these efforts. There are now gene therapies that can treat genetic blindness. Young children who previously would have been condemned to certain death at the hands of a rare disease, such as severe spinal muscular atrophy, now have a chance at life. The government invested in mRNA technology for decades before it was leveraged to create vaccines that saved us from a once-in-century pandemic.

One particularly dispiriting departure is that of Peter Marks, the longtime leader of the FDA’s Center for Biologics Evaluation and Research. I’d guess that, unlike me, you didn’t spend the early pandemic binge-watching scientific meetings where vaccine policy was debated. Marks was impossible to miss—a bespectacled man speaking from a bunkerlike basement, a painting of a polar bear serving tea behind him. He gets a hefty portion of credit for Trump’s Operation Warp Speed, the effort to turbocharge the development of COVID vaccines, and he came up with the moniker. His center also regulates gene therapies, stem cells, and the U.S. blood supply.

Marks reportedly resigned under pressure from Kennedy on Friday, just before mass firings hit the FDA. The two men—one, America’s top vaccine regulator and the other, its top vaccine-conspiracy theorist—have a long history. In 2021, when Children’s Health Defense, the anti-vaccine organization formerly chaired by Kennedy, petitioned the FDA to revoke authorization for COVID shots, Marks is the one who signed the letter denying the request. It’s reasonable to assume that Kennedy and Marks were never going to see eye to eye on vaccines. But Marks publicly insisted that he wanted to stay in his role, and that he was willing to work with Kennedy. In a resignation letter, Marks wrote that Kennedy demanded nothing short of “subservient confirmation of his misinformation and lies.” (Marks declined to comment for this story.)

Of course, not all 10,000 people who were fired had this type of history with their new boss. But the cuts, in many ways, appear to be rooted in a similar antagonism. In his welcome address to HHS staff in February, Kennedy offered reassurance that he was not coming in with biases, and said that people should give him a chance. “Let’s start a relationship by letting go of any preconceptions that you may have about me, and let’s start from square one,” Kennedy told the crowd. “Let’s establish a mutual intention to work toward what we all care about, the health of the American people.” In firing a huge swath of his staff, Kennedy has made clear what he believes: Anyone with an HHS badge is complicit in the current system, whether or not they have anything to do with the country’s health problems. As Calley Means, a top adviser to Kennedy, said during a Politico health-care summit earlier today, the scientists who were laid off “have overseen, just demonstrably, a record of utter failure.”

Kennedy can argue all he wants that the focus of federal health agencies needs to shift more toward chronic disease. Means and other MAHA acolytes are right that, in some ways, America has gotten less healthy and federal bureaucrats haven’t done enough to solve the problem. But decimating the entire health bureaucracy in this country is not proving his point. Kennedy doesn’t look like he is setting the agencies on a productive new course. He looks like he’s just out for revenge.


Katherine J. Wu contributed reporting.

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